2018 Volume 51 Issue 1 Pages 72-80
A 62-year-old man underwent colonofiberscopy because of a positive fecal occult blood test, and we diagnosed rectal neuroendocrine tumor (NET) G1. Colonofiberscopy and endosonography showed a 5-mm submucosal tumor, which contained some high echoic spots, at the 4 cm level from the anal verge. Because CT and MRI showed some swollen lateral lymph nodes on the left side, we diagnosed rectal NET with lateral lymph node metastases and performed intersphincteric resection with bilateral lymph node dissection. Histopathological examination confirmed that the origin was a 9-mm rectal NET G1, v (−), ly (+), and metastatic to three left lateral lymph nodes. The patient remained disease-free for 19 months after surgery without any adjuvant therapy. Most studies have described the lymph node metastasis of rectal NET in the mesorectum, and few have reported lateral lymph node metastasis. Our findings suggest that the care is necessary about the lateral lymph node metastasis of even small rectal NET.
